Objective To introduce the preliminary experience of using rigid neuroendoscope in repair of spinal meningocele or myelomeningocele. Methods 3 infantile patients aging between 13 months and 22 months underwent the resection and repair of spinal meningocele or myelomeningocele in May, 2013. The operations were performed under the direct visualization of the rigid neuroendoscope in the aid of the intraoperative electrophysiological monitoring. All the surgical manipulations were accomplished outside the sheath of the endoscope. Results The surgical procedures were smooth. All the patients recovered satisfactorily. There was no postoperative complication. At the one-year follow-up, they were developing normally. Conclusions The rigid neuroendoscope is useful to the resection and repair of spinal meningocele and myelomeningocele. It could simplify the surgical procedures.

Objective To investigate the effect of the nursing care of critically ill patients in intensive care unit(ICU) with non-invasive ventilation assisted by sedation simultaneously. Methods During the intervention phase from June 2012 to June 2013 of 28 patients in ICU treated by non-invasive ventilation, sedatives were adjusted according to Ramsay Scale, and the parameters of the life signs (heart rate, blood pressure, oxygen saturation,etc) were measured by nurses. Results 89.3%(25/28) patients obtained the improvement of the disease despite of the complications such as over-sedation and instable hemodynamics. Conclusion The key points can increase tolerance of non-invasive ventilation and improve clinical outcomes, develop comprehensive nursing strategies on safety and effectiveness of sedation and non-invasive ventilation .

Objective To investigate the protective effects of rhein lysinate (RHL)on the blood vessel damage induced by oxidative stress in the mice,and to explore its mechanism.Methods The mouse models of oxidative damage were established by intraperitoneal injection of paraquat.30 C57 mice were randomly divided into control, paraquat model,and RHL prevention groups.The mice in RHL prevention group were given RHL by gavage for one week before performing model.The mice in other two groups were given equal volume of distilled water.For making model,paraquat was intraperitoneally injected in the mice in paraquat model and RHL prevention groups once a week for two weeks.The activities of superoxide dismutase (SOD)and glutathione peroxidase (GSH-Px) and the content of serum malonaldehyde (MDA) of the mice were detected 2 weeks after modeling. The pathological profile of blood vessel was observed by hematoxylin and eosin (HE)staining and the level of reactive oxygen species was observed by DCFH-DA staining.The expressions of genes related to blood vessel damage were detected by Western blotting method.Results Compared with control group,the activities of SOD and GSH-Px were decreased and the content of MDA was increased in paraquat model group (P < 0.05 ). Compared with paraquat model group,the activities of SOD and GSH-Px were increased and the content of MDA was decreased in RHL prevention group (P <0.05).The pathological examination indicated the structure of blood vessel of the mice was damaged and the level of reactive oxygen species of blood vessel was increased (P <0.05)in paraquat model group.The pathological changes were significantly improved and the level of reactive oxygen species of blood vessel of the mice was decreased (P < 0.05 )in RHL prevention group. The Western blotting analysis showed that compared with control group,the expression levels of nitric oxide endothelial synthase (eNOS)and caspase-3 of the mice in paraquat model group were decreased (P < 0.05),however the expression level of cleaved fragment of caspase-3 was increased (P < 0.05).Compared with paraquat model group,the expression levels of eNOS and caspase-3 of the mice in RHL prevention group were increased (P < 0.05 )and the expression level of cleaved fragment of caspase-3 was decreased (P <0.05).Conclusion Paraquat could induce vascular cell damage in vivo through increasing the levels of reactive oxygen species, and RHL could antagonize the effects of paraquat by scavenging reactive oxygen species, and up-regulating the eNOS expression and reducing the expression of the cleaved fragment of caspase-3.

Objective:To explore the correlation between fluoride intake and serum alkaline phosphatase (ALP) in pregnant women of different gestational periods in endemic fluorosis area.Methods:Pregnant women in Rencheng District, Jinxiang County, Jiaxiang County of Jining City and Yuncheng County of Heze City were selected in April 2020. According to the gestational weeks, pregnant women were divided into early pregnancy group (0 - 12 weeks), middle pregnancy group (13 - 27 weeks) and late pregnancy group (> 27 weeks). The levels of urinary fluoride, ALP, osteocalcin (BGP), C-terminal peptide of β-Ⅰ collagen (β-CTX) and N-terminal propeptide of type Ⅰ collagen (PINP) of pregnant women in each group were measured, and the correlation between urinary fluoride and ALP, BGP, β-CTX, and PINP in pregnant women of different gestational periods was analyzed.Results:A total of 372 pregnant women were selected, including 97 cases in early pregnancy group, 169 cases in middle pregnancy group and 106 cases in late pregnancy group. There was no significant difference in urinary fluoride level between the three groups [(1.20 ± 0.25), (1.23 ± 0.19), (1.24 ± 0.30) mg/L, P > 0.05]. There was significant difference in serum ALP among the three groups ( P < 0.05), among them, the ALP level in early pregnancy was significantly lower than those of middle pregnancy group and late pregnancy group ( P < 0.05), and the ALP level in middle pregnancy was significantly lower than that of late pregnancy group ( P < 0.05). There was no significant differences in serum β-CTX among the three groups ( P > 0.05). There were significant differences in serum BGP and PINP levels among the three groups ( P < 0.05). The serum BGP and PINP levels in late pregnancy group were significantly higher than those of early pregnancy group and middle pregnancy group ( P < 0.05), and there were no significant differences in serum BGP and PINP levels between early pregnancy group and middle pregnancy group ( P < 0.05). There was a significant positive correlation between urinary fluoride and ALP in early pregnancy group ( r = 0.364, P < 0.05), but no significant correlation between urinary fluoride and BGP, β-CTX and PINP ( r = 0.164, 0.117, 0.136, P > 0.05). There was a significant positive correlation between urinary fluoride level and ALP in middle pregnancy group ( r = 0.417, P < 0.05), but no significant correlation between urinary fluoride level and BGP, β-CTX and PINP ( r = 0.127, 0.108, 0.129, P > 0.05). There was no significant correlation between urinary fluoride level and ALP, BGP, β-CTX and PINP in late pregnancy group ( r = 0.179, 0.158, 0.184, 0.149, P > 0.05). Conclusions:The urinary fluoride level of pregnant women in endemic fluorosis area is relatively stable in gestational period. The urinary fluoride level affects the ALP secretion of pregnant women in early and middle pregnancy. It is still necessary to strengthen the measures of improving water quality and defluoridation to reduce the impact of excessive fluoride intake on pregnancy complications in endemic fluorosis area.

OBJECTIVE Toprepareapolyclonalantibodyforspindlin1protein,anovelcancer related protein,and to provide the data for a better understanding of its functions and screening tu mor. METHODS Purifiedspindlin1proteinwasinjectedintorabbitstoproducethepolyclonalantiserumafter removing glutathione S-transferase (GST)from the fusion protein spindlin 1-GST that was expressed in Escherichia coli..The antiserum was purified through the Hitrap Protein A system,and the titer of spin-dlin 1 polyclonal antibody was detected by ELISA.The specificity of the polyclonal antibody was deter-minedbyWesternblottingandimmunohistochemistry.RESULTS Thetiterofspindlin1polyclonalanti-body was 1∶2000.Western blotting detection demonstrated that the spindlin 1 polyclonal antibody recog-nized myc-spindlin 1 reco mbinant fusion protein in HeLa cells transfected with pAdeasy-myc-spindlin 1 , which also corresponded with Myc.antibody.The HeLa cells were transfected with enhanced green fluo-rescence protein (EGFP)and spindlin 1 vector(pEGFP-C3-spindlin 1 ),which was confirmed by the in-dependent GFP fluorescence assay.The results of immunohistochemistry detection with the spindlin 1 polyclonal antibody suggested that spindlin 1 was mainly expressed in the nuclei of HeLa cells.More i m-portantly,in i mmunohistoche mical assays,the spindlin 1 antibody recognized nuclear spindlin 1 expres-sioninclinicalovariancancertissues.CONCLUSION Thespecificspindlin1polyclonalantibodyispre-pared,which may be used to detect cancer-related protein spindlin 1 in HeLa cells and ovarian cancer tissues.

Objective To discuss the clinical value of magnetic resonance imaging in the diagnosis of inner ear lesion.Methods 94 patients who took magnetic resonance imaging water imaging were selected as study subjects from February 2014 to October 2016 in Heilongjiang Province Hospital.All the patients had surgical data,CT,MRI water imaging data.Based on the standard data of surgery gold,analyzed the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of CT and MRI in the diagnosis of inner ear lesions,compared the statistical differences between the two methods of examination.Results The sensitivity,specificity,positive predictive value and negative predictive value of MRI water imaging in diagnosis of inner ear werehigher than CT,but the differences were no statistically significant (all P ＞ 0.05).In the case of abnormal vestibular aqueduct (x2 =7.265,P =0.015),cochlear deformity (x2 =5.042,P =0.028),diagnostic accuracy of cochlear fibrosis (x2 =5.492,P =0.027),the differences were statistically significant(all P ＜ O.05).Conclusion MRI water imaging can effectively provide the information of ear canal,eudometrial and other internal organs,can provide a favorable clinical diagnosis,it is worth to promote the application in the clinical work.

External snapping hip(ESH) is a vague term used to describe palpable or auditory snapping with hip movements with or without pain. The pathogenesis of ESH is related to the specific anatomical structure and friction factor. The clinical symptom is auditory snapping during activities, physical examination, X-ray, magnetic resonance imaging(MRI), dynamic ultrasound and other imaging techniques can be used to diagnose. Conservative medical management includes rest, avoidance of aggravating activities, and antiinflammatory medications. Treatment Patients with mild symptoms can achieve good results by medication, rest and physiotherapy. Surgical treatment for patients with ineffective conservative treatment was performed. All kinds of open surgery method can achieve good clinical curative effect, arthroscopic surgery is gradually been promoted due to small trauma, less complications. Besides, there are some reports that traditional treatments such as massage, acupuncture and acupotomology have achieved good clinical results, which deserve further study and promotion.

Objective To investigate the influencing factors of thirst among intensive care unit patients. Methods A total of 354 intensive care unit patients were selected from the Second Affiliated Hospital of Harbin Medical University, and the occurrence of thirst was investigated with the general information questionnaire, xerostomia inventory in the first 48 hours in ICU. The relationship of general information and clinical data was analyzed. Results Thirst was common in patients with ICU.Logistic regression analysis showed that age,personal history,past medical history,balance quantity of 24 hours, diuretic, vasoactive drugs, oxygen way, serum sodium concentration, osmotic pressure, PaO2were independent factors of thirst. Conclusions The conditions of thirst in different patients are different and are affected by many factors.Interventions should be taken aimed at the influencing factors to improve the intervention quality.

Objective To investigate the clinical efficacy of internal fixation through posterior minimally invasive approach in treating unstable scapula fractures.Methods A retrospective case control study was conducted on the clinical data of 36 patients with scapular fractures admitted between May 2011 and August 2016.There were 30 males and six females,with average age of 51.5 years (range,46-64 years).According to Hardegger classification,there were 18 patients with scapular body fracture,14 with scapular neck fracture,and four with glenoidal fracture.According to operation method,the patients were divided into Group A (n =24) which adopted internal fixation through posterior minimally invasive approach and Group B (n =12) which adopted the conventional Judet approach for internal fixation.The incision length,operation time,intraoperative bleeding,fracture healing time,Hardegger standard of clinical effects,and complications in two groups were compared.Results All patients were followed up for average 18 months (range,6-24 months).The total length of surgical incision was (12.50 ± 4.50) cm in Group A and (27.95 ± 5.20) cm in Group B (P ＜ 0.05);the operation time was (86.5 ± 1 1.5) minutes in Group A and (120.6 ± 10.9) minutes in Group B (P ＜ 0.05);the intraoperative bleeding was (200.0 ± 20.0)ml in Group A and (420.0 ± 20.0)ml in Group B (P ＜ 0.05);fracture healing time was (10.0 ± 1.0) weeks in Group A (12.0 ± 1.5) weeks in Group B (P ＜ 0.05).According to Hardegger standard,in Group A,15 patients were excellent,six good,and two fair,with an excellent and good rate of 91％;while in Group B,six patients were excellent,three good,two fair,and one poor,with an excellent and good rate of 75％ (P ＜ 0.05).No complications were observed in Group A.In Group B,one patient with hematoma and one patient with nonunion of incision area were observed,both of which recovered after drainage and dressing change.One patient with superior scapular nerve injury was found and recovered after treatment.The incidence of complications was 25％ in Group B,higher than 0 in Group A (P ＜ 0.05).There was no internal fixation fracture or nonunion in two groups.Conclusion Compared with the conventional Judet approach,minimally invasive internal fixation approach in the treatment of unstable scapula fracture demonstrates the advantages of mild trauma,faster functional restoration,and fewer complications.

Objective To evaluate the effect of PAD bundle in mechanically ventilated patients for preventing delirium. Methods Two hundred and forty three patients with mechanical ventilation who were admitted in ICU from January 2015 to February 2018 were divided into two groups according to the method of random number table. The patients in the control group(120 cases) received routine nursing care. The patients in the experimental group(123 cases) received the PAD bundle on the basis of routine nursing care. The scores of Richards Campbell Sleep Questionnaire(RCSQ), the doses of sedatives and analgesics, incidence of delirium, duration of delirium, ventilator time, ICU length of stay and the 28-day ICU mortality were compared between the two groups. Results The incidence of delirium, duration of delirium, ventilator time, ICU length of stay was 23.58％(29/123), (2.83±1.20) d, (153.07±55.61) d, (7.88± 2.89) d in the experimental group, 40.00％(48/120), (4.02 ± 1.99) d, (170.90 ± 63.51) d, (10.13 ± 3.41) d in the control group, and there was significant difference between the two groups (χ2=8.298, Z=2.840, 2.276, 5.325, P <0.01 or 0.05). The total score of RCSQ was (55.23 ± 17.89) points in the experimental group, (51.86±16.45) points in the control group, and there was significant difference between the two groups(Z=5.654, P<0.05). There was no significant difference in 28-day ICU mortality between the two groups (P>0.05). Conclusions The PAD bundle can decrease the incidence of delirium, the duration of delirium and improve prognosis of the patients with mechanical ventilation.